Overprescribing of potentially harmful medication: an observational study in England's general practice.

IF 2.5 Q2 PRIMARY HEALTH CARE

BJGP Open Pub Date : 2024-07-29 Print Date: 2024-07-01 DOI:10.3399/BJGPO.2023.0156

Tasneem Khan, Bethan Copsey, Paul Carder, Stella Johnson, Mohammed Imran, Kaiwen Wang, Sarah Alderson

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Abstract

Background: Overprescribing of potentially harmful medication in UK general practice has a complex association with socioeconomic deprivation.

Aim: To assess trends in general practice prescribing of five high-risk medications and their relationship with deprivation.

Design & setting: An observational study was conducted using general practice data from three English regions with varied sociodemographic factors: West Yorkshire and Harrogate (WY), Black Country and West Birmingham (BC), and Surrey and East Sussex (SE).

Method: Practice-level prescribing data were obtained from 2016-2021 for five drug classes: opioids, hypnotics, gabapentinoids, non-steroidal anti-inflammatory drugs (NSAIDs), and antibacterials. Prescribing trends were demonstrated using a linear model.

Results: Reduction in NSAID, opioid, hypnotic and antibacterial prescriptions, and the increase in gabapentinoid prescriptions, were significant at each financial year time period. Index of Multiple Deprivation (IMD) was positively associated with all drug classes except antibacterials, which showed a positive association when incorporating the interaction term between IMD and age.When adjusting for IMD and population, region was independently associated with prescribing rate. Compared with WY, IMD had a smaller association with prescribing in BC for NSAIDs (coefficient = -0.01578, P = 0.004) and antibacterials (coefficient = -0.02769, P = 0.007), whereas IMD had a greater association with prescribing in SE for NSAIDs (coefficient = 0.02443, P<0.001), opioids (coefficient = 0.08919, P<0.001), hypnotics (coefficient = 0.09038, P<0.001), gabapentinoids (coefficient = 0.1095, P<0.001), and antibacterials (coefficient = 0.01601, P = 0.19).

Conclusion: The association of socioeconomic deprivation with overprescribing of high-risk medication in general practice varies by region and drug type. Geographical location is associated with overprescribing, independent of socioeconomic status.

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过量开具可能有害的药物：英格兰全科医生的观察研究。

背景：目的：评估全科医生开具五种高风险药物处方的趋势及其与贫困的关系：我们利用英国三个社会人口因素各不相同的地区的全科医生数据开展了一项观察性研究：西约克郡和哈罗盖特（WY）、黑乡和西伯明翰（BC）以及萨里和东萨塞克斯（SE）：获得了 2016-2021 年实践层面的五类药物处方数据：阿片类、催眠药、加巴喷丁类、非甾体抗炎药 (NSAID) 和抗菌药。使用线性模型显示了处方趋势：结果：非甾体抗炎药（NSAID）、阿片类药物、催眠药和抗菌药处方量的减少以及加巴喷丁类药物处方量的增加在每个财政年度的各个时间段都非常显著。多重贫困指数（IMD）与除抗菌药以外的所有药物类别均呈正相关，而抗菌药与多重贫困指数和年龄之间的交互项呈正相关。与 WY 相比，IMD 与 BC 的非甾体抗炎药（系数 -0.01578，P=0.004）和抗菌药（系数 -0.02769，P=0.007）处方相关性较小，而 IMD 与 SE 的非甾体抗炎药处方相关性较大（系数 0.02443，PPP=0.19）：结论：社会经济贫困与全科医生开具高风险药物处方过多的关系因地区和药物类型而异。地理位置与开药过多有关，与社会经济地位无关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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